Treatment regimen adherence in pediatric gastroenterology.
OBJECTIVE
To review and critically evaluate the extant research pertaining to adherence in pediatric gastroenterological diseases, particularly inflammatory bowel disease and celiac disease, and to provide recommendations for future research development.


METHODS
A literature search with no date restriction was conducted using PubMed and PsychInfo electronic databases and bibliographies of relevant articles.


RESULTS
Adherence rates in inflammatory bowel disease and celiac disease range considerably from 16% to 62% and 5% to 70%, respectively, across treatments and assessment method; nonadherence frequency was generally not reported. Measures used to assess adherence included self-report, interview, diet record, and bioassay methods, and each measure demonstrated strengths and limitations. Limited evidence suggests that adherence in both disease populations is related to patient and family behavioral factors and that nonadherence is related to poor disease outcome. Treatment outcome research for nonadherence is scant in the current literature.


CONCLUSIONS
Future research should focus on refining assessment method, examining adherence and concomitant behavioral factors longitudinally, testing theoretical models of adherence, and developing efficacious treatments for nonadherence.
Hommel
Kevin A
KA
Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. kevin.hommel@cchmc.org
Mackner
Laura M
LM
Denson
Lee A
LA
Crandall
Wallace V
WV
D002648:Child; D005762:Gastroenterology / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology / Q000628:therapy; D010349:Patient Compliance